Assessment of Admission Time Cell Blood Count (CBC) Parameters in Predicting Post-primary Percutaneous Coronary
Hossein Vakili1, Isa Khaheshi1, Amirsina Sharifi2
1Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Admission complete blood count (CBC) parameters like white blood cell, neutrophil, and platelet counts may predict no-reflow after primary percutaneous coronary intervention (PPCI) in ST-Elevation Myocardial Infarction (STEMI) patients.
Area of Science:
- Cardiology
- Hematology
- Interventional Cardiology
Background:
- No-reflow phenomenon after primary percutaneous coronary intervention (PPCI) for ST-Elevation Myocardial Infarction (STEMI) is a significant clinical challenge.
- Predicting no-reflow is crucial for optimizing treatment strategies in STEMI patients.
- Existing research shows varied results regarding reliable predictors of no-reflow.
Purpose of the Study:
- To evaluate the predictive value of admission complete blood count (CBC) parameters for corrected Thrombolysis in Myocardial Infarction (TIMI) frame count after PPCI.
- To identify specific CBC parameters that correlate with post-PPCI corrected TIMI frame count in STEMI patients.
Main Methods:
- A study involving 208 consecutive STEMI patients undergoing PPCI.
- Admission blood samples were analyzed within 5 minutes of collection.
- Correlation and multiple linear regression analyses were used to assess the relationship between CBC parameters and post-PPCI corrected TIMI frame count.
Main Results:
- Corrected TIMI frame count showed a positive correlation with White Blood Cell (WBC) count, neutrophil count, and platelet count.
- A negative correlation was observed between corrected TIMI frame count and lymphocyte count.
- Multiple regression confirmed positive correlations with neutrophil and platelet counts, and a negative correlation with lymphocyte count.
Conclusions:
- Elevated WBC, neutrophil, and platelet counts, along with low lymphocyte counts, may serve as predictors of no-reflow in STEMI patients undergoing PPCI.
- These findings highlight the clinical significance of readily available CBC parameters for risk stratification.
- Accurate risk stratification can lead to improved treatment planning and resource allocation for STEMI patients.
Objectives:
In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count.
Background:
Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing.
Methods:
The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients' clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed.
Results:
Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004).
Conclusion:
High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources.
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